... cogitating the possibilities by the sound of my own keystrokes ...

March 28, 2007

But to researchers who study deceptive patients, there is no such thing as a blatant red flag. Deception is notoriously difficult to spot, as Dr. Beth F. Jung and Dr. Marcus M. Reidenberg of Cornell University, document in a new survey of the literature. They note, for starters, an experiment showing that even police officers and judges — ostensibly experts at detecting fraud — do no better than chance at detecting lying.

Doctors are especially gullible because they have a truth bias: they are trained to treat patients by trusting what they say. Doctors are not good at detecting liars even when they have been warned, during experiments, that they will be visited at some point by an actor faking some condition (like back pain, arthritis or vascular headaches). In six studies reviewed by the Cornell researchers, doctors typically detected the bogus patient no more than 10 percent of the time, and the doctors were liable to mistakenly identify the real patients as fakes.

I am not so sure about the "gullible doctor" part. From what I've seen, too many doctors (and nurses) are quick to assume drug-seeking behavior. And I can't tell you how many times I've heard nurses say they won't give another dose of narcotics based on the fact that the patient fell asleep.

Like I've said before, if we don't do something, you will probably spend your final days in unrelenting pain, surrounded by healthcare workers that will call you a drug addict to your face.

March 25, 2007

A couple of pictures of beloved pets affected by the rat poisoning. The little dog on the right is dead from kidney failure. The white kitty on the right is suffering from kidney failure. I remember when I first heard about it, I went through all of our kitty products, and bags of food. None were produced by Menu Foods, the company that has announced a recall of all tainted products. You can really tell where my priorities are. As I ransacked the cupboards looking through kitty food and treats, I ran into three cans of peanut butter (recently tainted with salmonella). (Of course, I did tell the room mate not to eat the peanut butter). I can't imagine what we'd do if feeding our kitties had hurt them, or even killed them.

At issue are individual policies, the type needed by consumers who cannot get group coverage from employers or others. Although insurers cannot deny coverage to members of group plans, state law allows insurers to deny granting individual policies to applicants with preexisting medical conditions.

The state investigation found that Blue Cross used computer programs and a dedicated department to systematically investigate and cancel the policies of pregnant women and the chronically ill regardless of whether they intentionally lied on their applications to cover up preexisting medical conditions — a standard required by state law for canceling individual policies.

There are too many people who are living so close to the edge that one serious illness destroys life as they know it, and then they are told they won't get covered by their insurance plan.

But as the housing market cools, thousands of subprime borrowers are struggling to keep their homes. A number of subprime lenders, saddled by failed loans and a shortage of cash, have folded or staggered. In some particularly hard-hit neighborhoods in Denver's suburbs — one of a few metropolitan areas where the problem is especially grave — home after home sits dark.

Clearly, this isn't how the American dream is supposed to play out, but who's to blame?

The experience of families like the Snearys show how the squeeze created by questionable lending can quickly be compounded by family economic crises, a lack of planning and knowledge, and the rapid shifts in a real estate market that once seemed unstoppable.

"You were set up to fail," one real estate agent told them.

It's a sobering thought for anybody who shares the American dream. After all, it hits so close to home.

The roses will come every year,and they will only stop,When your door's not answered,when the florist stops to knock.

He will come five times that day,in case you have gone out.But after his last visit,he will know without a doubt!To take the roses to the place,where I've instructed him,and place the roses where we are,together once again.

March 20, 2007

I have become a fan of Veronica Mars. At first, I dismissed the show as another Dawson's Creek or The O.C. type show, but the acting is great, and the stories are exciting. I've been watching the current season, and now I'm watching the first season on DVD. One thing that I have noticed is that the show had well developed characters and relationships right from the first episode. Unlike most shows, which need a few years for the characters to settle in, the first season has the same feel as the last. And my goodness how techie. Cell phones, lap tops, GPS trackers, digital SLR cameras, just the whole bit.

One of those shows I love to hate, and hate that I love. A lot of fans have given up on the show because they are always promising to answer a lot of questions, but they don't seem to be answering the questions I am asking. But the stories are riveting. I am glued to the screen, soaking up every detail. But when the episode ends, I end up screaming at the television. What's up with the polar bears? What's up with the smoke? Where did Michael and Walt go? Does Walt have some sort of super power? In the series finale, will they all find out that they are the ones that are dead? What's up with this show?

March 16, 2007

I've never done mouth-to-mouth breathing, not in either my personal or professional life. I have always been lucky in that, whenever we have had to initiate CPR, someone has usually shown up with the ambu-bag really early in the process.

So I read from KevinMD who linked to news that, perhaps, not only is it not harmful to omit this step, it might actually be doing harm to perform rescue breathing:

Studies showed that because current CPR guidelines call for mouth-to-mouth ventilations, the majority of people would not perform CPR on a stranger, partly out of fear of contracting diseases. Research by UA Sarver Heart Center member Karl B. Kern, MD, and others found that even if bystanders are willing to perform mouth-to-mouth ventilation, it takes too much time away from chest compressions, which have to be continuous to improve the chance of survival.

There are some notable exceptions to the "Bag the Breathing" idea, especially drownings, child/infant CPR (where most cardiac arrests are caused initally by respiratory problems such as drowning or choking) or drug overdose.

March 14, 2007

I have had quite an appetite for reading. I finally managed to get my hands on a library copy of Michael Crichton's Next. He is good at writing likable heroes, and there are several in this book, including two talking apes, a talking bird (that has been watching too much TV and loves country music) and a room full of nerds that got straight A's in Biology.

I'm also hugely impressed by the bibliography at the end of the novel. He certainly did his scientific homework.

But the talking bird dialogue was funny as hell.

A pre- prequel to Silence of the Lambs. Hannibal Risingdescribes how Hannibal Lechter survived the Nazi's, and was warped by them. I thought it would be another thriller-mystery story, and I guess it is (he kills a few people but, as usual, they're just "free range" trashy folks). He matches wits with another investigator/detective type.

The last time we took pictures at the zoo, all of the photos came out the same dull washed-out blend of brown, tan and muted green. I like this picture that my room mate took of some baboons. Taken through a glass window, it is somewhat blurred because the auto-focus had a hard time with the reflection. But I like the dramatic colors in the faces. And the guy in front -- loneliness? despair? unrequited love?

March 08, 2007

Well, he wanted to do something a tad different from Harry Potter. I remember the original version of this movie, originally starring Richard Burton as the psychiatrist, and Peter Firth as the young man. I was in my last year of William and Mary. My room mate at the time (who is now a psychiatrist) and I invited three of our best friends over to watch the VHS version, all of us seated on the floor in our un-furnished apartment (it did have a chair, a table, a lamp and a TV that sat on the floor).

We found it totally captivating, and I am sure set the tone for a lot of long therapeutic discussions in our professional futures (Richard Burton, for instance, taught us that giggling or looking incredulously at your patient limits the therapeutic outcome).

Over the years, I have tried to show that VHS version of Equus to a variety of folks, and none ever got as much as the five of us did. I am sure this new version will be just as significant and competent as earlier film version. I would love to see the play in person.

A former teacher of mine was telling me he had seen the play at William and Mary, and that no one had told him or his date that there would be so much nudity, or that the basis for the psychosis would be so dramatic and shocking. I remember him telling me that, after having a nice dinner at The Trellis in Colonial Williamsburg, they walked to campus and were perplexed when there were signs taped secretively at the hall entrance, which led the hushed patrons around a back door and down a dark stairwell and into a smaller theater in the basement. My teacher said that the stage was very small, and that the stage was completely surrounded on all sides by the audience. At one point, the actor (now played by Dan Radcliffe but then played by one of William and Mary's theater students I suppose) threw himself into the small aisle between the seats, such that he and his date were basically sitting right next to this screaming, crying, hypnotized -- and completely naked -- college-aged actor.

My goodness.

I once attended a drag show in Washington DC, and one of the drag queens got a hilarious kick out of sitting on my lap backwards, and shoving her fake boobs all over my face. For a moment, I thought I would be suffocated and die. I could barely breathe, due to a combination of being sat on and laughing hysterically. And I was spending a lot of my cognitive powers trying to figure out if the boobs were real. Not paying attention, I gave her a $20 tip (don't ask where I put it) and almost didn't have cab fare back to our hotel.